脑室内原发性中枢神经系统淋巴瘤的MR诊断及文献回顾

目的总结脑室内原发性中枢神经系统淋巴瘤的影像学特点,增加对该病的系统性认识,提高对该病的影像诊断水平。方法回顾性分析7例经手术病理确诊的脑室内淋巴瘤患者的影像特点。结果脑室内淋巴瘤的影像表现具有一定特点,本组4例病灶位于侧脑室内,3例位于第四脑室内,其中2例合并脑实质内病灶,7例病灶均表现为实性等信号影,5例可在病灶内见囊变区;增强扫描后7例病灶均明显强化,其中5例表现为与脉络丛分界不清,5例表现为沿着脑室壁爬行生长,呈铸形;仅1例行DWI序列的患者表现为整个肿瘤扩散受限影;3例有CT检查的患者均表现为稍高密度影,其中1例可见条块状钙化。结论发生于脑室内的实性占位性病变,CT扫描呈稍高密度影,静脉注入对比剂可见明显强化且与脉络丛及脑室壁均关系紧密者,应考虑到脑室内淋巴瘤的可能。

MRI diagnosis of intraventricular primary central nervous system lymphoma

Objective To summarize the MRI appearance of intraventricular primary central nervous system lymphoma (IVPCNL). Methods MRI of 7 patients with pathological confirmation of IVPCNL was retrospectively analyzed. Results The lesions were found in the lateral (4) or 4th ventricle (3) with 2 involving the brain parenchyma as well. All 7 masses were solid, isointense on both T1-and T2-weighted images with necrosis in 5. Marked contrast enhancement in all lesions without delineation from the choroid plexus (5), and tumor spread along the ventricular wall (5). Reduced diffusion was noted in the tumor on diffusion-weighted imaging in 1 patient. Three lesions were hyperdense on CT with cord-like calcification (1). Conclusion IVPCNL should be considered in solid intraventricular masses with hyperdensity on CT, T1-and T2 isointensity, and marked contrast enhancement close to the choroid plexus and ventricle wall.